The Clinical Research Of H-type Hypertension And Prethrombotic State

Objective:1. To explore the clinical characteristic of H-type hypertension,in order to make thediagnosis and treatment of the H-type hypertension more certificated in clinical.2. By detecting the molecular marker of the damaged vascular endothelial cells and theprethrombotic state, statisting the intima-media thickness and atherosclerotic plaques ofcarotid artery, to discuss the mechanism of the inclination of thrombotic disease in thepatients of H-type hypertension,and providing objective evidence for early clinical diagnosisand therapy of H-type hypertension.Methods:Collected191cases of outpatients or inpatients with essential hypertension from thefirst hospital of jilin university between june2012to september2013,and divided into groupof H-type hypertension(n=128)and group of simple hypertension(n=63) according to theplasma levels of homocysteine. In addition, choosed36cases for physical examination in thesame period as the healthy control group.All the subjects were measured the systolicpressure, diastolic pressure accurately,and calculated the pulse pressure.Usingenzyme-linked immunosorbent assay(ELISA) to determine the plasma ET-1、 vWFconcentration of every cases. Using nitrate reduction method to determine the plasma NOconcentration of every cases. The data of hcy、folic acid、vitamin B12、fibrinogen、D–dimer、fasting blood-glucose、renal function、color doppler ultrasound of carotid artery andthe gender、age、previous history、family history were all registered. All statistical data wereanalyzed by using SPSS software version21.0.Results:1. All the objects with essential hypertension in our research, EH combined hhcyaccounted for67.02%, EH unincorporated hhcy accounted for32.98%.2. Compared with group of simple hypertension and group of healthy control, theplasma level of folic acid and vitamin B12in the group of H-type hypertension decreasedsignificantly(P﹤0.05), the correlation analysis shows that the level of plasma hcy was negatively correlated with the level of folic acid and vitamin B12.3．There were significant differences among the blood pressure classification of the hcylevel in the group of H-type hypertension.Plasma hcy level was higher with the increase ofblood pressure classification（P﹤0.05).4．The plasma hcy level of male was higher than female in the group of H-typehypertension, the difference was tatistically significant（P﹤0.05）.5．The levels of plasma vWF、ET-1、D–dimer and FBG in group of H-typehypertension were significantly higher compared with group of simple hypertension andgroup of healthy control（P﹤0.05），while the level of plasma NO was lower than the othertwo groups（P﹤0.05）. vWF、ET-1、D–dimer and FBG in group of simple hypertensionwere higher than group of healthy control（P﹤0.05）,NO was lower in group of simplehypertension than in group of healthy control（P﹤0.05）.6．The IMT of the carotid artery in the group of H-type hypertension was thicker thanthe other two groups(P﹤0.05), the atherosclerotic plaque detection rate was significantlyincreased(P﹤0.05).The IMT in the group of simple hypertension was thicker than the groupof healthy control, but there was no statistically significant difference （P﹥0.05）, whilethe atherosclerotic plaque detection rate was significantly increased, the difference wastatistically significant（P﹤0.05）.Conclusion:1. Folic acid and vitamin B12are the cofactor in the metabolic process of hcy,Hhypertensive patients are short of folic acid and vitamin B12widely,the level of plasma hcyis negatively correlated with the level of folic acid and vitamin B12.2. There is correlation between hcy and hypertension, Plasma hcy level is higher withthe increase of blood pressure classification in the H hypertensive patients.3. There is gender differences in the plasma hcy concentration, the plasma hcy level ofmale is higher than female.4. Both EH and hcy can cause endothelial cell to be injured and lead to atherosclerosis,the two cooperates with each other. Prethrombotic state is related to endothelial cellinjury,both H-type hypertension and simple hypertension can lead to prethrombotic state，Hhypertensive patients are more likely to form prethrombotic state.